Blood in your urine is the most common initial bladder cancer symptom. Other symptoms include pain when urinating, a weak urine stream, or a frequent need to pee.

Bladder cancer signs and symptoms can be mistaken for those of a urinary tract infection (UTI) or bladder stones.

Although peeing blood is the most common symptom of bladder cancer, initial symptoms can vary between people. If you’re peeing a small amount of blood, it might only be visible on a urine test.

This article covers the most common symptoms of bladder cancer and how it’s diagnosed.

When to see a doctor

It’s critical to see your doctor if you develop any symptoms of bladder cancer without a known cause. It’s especially important if you have:

  • blood in your urine
  • a family history of bladder cancer
  • multiple risk factors for bladder cancer, such as smoking or workplace exposure to industrial chemicals

Blood in your urine is the first symptom of bladder cancer in about 80% of people who develop it. Blood may make your urine appear:

  • orange
  • pink
  • dark red

The blood in your urine will likely come and go and be painless.

If there’s a small amount of blood, your urine may not change color. It still may be detected with a urine test.

Initial symptoms of bladder cancer

In addition to blood in your urine, symptoms in about 20% of people with bladder cancer include:

These symptoms are usually associated with carcinoma in situ, or precancerous changes to your bladder. These symptoms can also be present in invasive cancer.

Rarely, the initial symptom of bladder cancer may be urinary obstruction, which may cause a weak urine stream or a complete inability to pass urine.

Later-stage symptoms of bladder cancer

Symptoms in people with advanced bladder cancer may include:

Bladder cancer that has grown large or spread to other areas may cause symptoms such as:

What other conditions cause similar symptoms?

Many conditions can cause similar symptoms as bladder cancer. These conditions include:

Unlike many other types of cancer, bladder cancer is often caught early. According to the National Cancer Institute’s SEER data from 2011-2020:

  • About 48.4% of bladder cancers in the United States were diagnosed in a very early stage.
  • 35.1% were diagnosed when the cancer was contained to the bladder.
  • Only 4.9% of cancers had spread to distant tissues at the time of diagnosis.

Diagnostic tests used

Doctors use the following tests to help diagnose bladder cancer:

  • Cystoscopy: Cystoscopy is a procedure where a thin tube with a camera and a light is inserted into your urethra to see the inside of your bladder.
  • Urine tests: Doctors can use urine tests to look for:
    • traces of blood
    • cancer or precancerous cells
    • substances linked to bladder cancer
  • Imaging: Imaging tests such as computed tomography (CT) scans or magnetic resonance imaging (MRI) can potentially help doctors see if your cancer has spread to other areas.
  • Intravenous pyelogram (urogram): Intravenous pyelogram is a special imaging test where dye is injected into your bloodstream and X-rays are taken of your urinary system.
  • Transurethral resection of a bladder tumor (TURBT): A TURBT involves removing the tumor and part of your bladder muscle. The cells will be examined under a microscope.

The results of a TURBT can be diagnosed in a lab to confirm your diagnosis and stage your cancer.

How common is bladder cancer, and who’s at risk for it?

The American Cancer Society estimates that about 82,290 new cases of bladder cancer will be diagnosed in the United States by the end of 2023. Men in the United States have about a 1 in 28 chance of developing bladder cancer. The odds for women are about 1 in 91.

Risk factors include:

Learn more about risk factors for bladder cancer here.

Blood in your urine is the most common initial symptom of bladder cancer. You might also experience pain when urinating, a weak urine stream, or a frequent urge to pee.

It’s important to note that these symptoms may mimic those of other conditions such as a UTI, enlarged prostate, or bladder stones.

It’s essential to visit your doctor any time you experience potential bladder cancer symptoms, especially if you have blood in your urine. Your doctor can help rule out other causes and recommend potential treatment options.